Why MACRA Matters

July 5, 2016 · Amy Maciejowski

Last week, CMS concluded its public comment period for the MACRA Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APM) proposed rule.

3,772 comments were filed. Ours was one of them.


MACRA changes how doctors get paid—transitioning from volume to value—and takes a big step forward for health care quality. The proposed rule details CMS’ implementation plan for administering MACRA’s new payment systems: MIPS and APM. MIPS adjusts fee-for-service payments into payments based on quality; APMs move clinicians away from fee-for-service payments toward capitation, or “payment-per-person.”

This change is monumental, and NCQA wants to help doctors and practices prepare for it. We want to be your resource as you chart MACRA’s unknown territories.

In the next few weeks, our blogs will expand on our original comments to CMS. They will delve deeper into what we think are the most important parts of the rule, and will discuss NCQA’s priorities for moving ahead. We’re also working on providing you with tools to map the lay of the land.

Key Points We Will Explore with MACRA

Here’s a sneak peek at future blog topics:

  • The rule importantly requires PCMH and PCSP recognition from a widely used, third-party program that is national in scope, to receive automatic full Clinical Practice Improvement Activity (CPIA) credit.
  • The importance of PCMH and PCSP recognition as it relates to MACRA: how recognition will help and how NCQA can support transformation.
  • Quality reporting in MIPS: the need for stronger criteria for performance measurement.
  • Concerns that the proposed rule will threaten small practices.
  • The need for a clear path to help clinicians join virtual groups in their journey to APM.

Be sure to check back every week for a new installment on MACRA. In the meantime, you can read our full comments here.

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